HomeMy WebLinkAbout17840-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No 217760 Date FEBRUARY 14, 1989
THIS CERTIFIES that the building ADDITION
Location of Property 185 MECHANIC STREET EAST SOUTHOLD
House No. Street Hamlet
County Tax Map No. 1000 Section 61 Block 04 Lot 29
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated FEB. 8, 1989 pursuant to which
Building Permit No. 178402 dated FEB. 14 1989
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued is FOR EXISTING ATTACHED DECK IN REAR OF HOUSE.
The certificate is issued to MIRLAM LYNNE RICHARDS
(owner, }
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL NfA
UNDERWRITERS CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
Building Inspector
Rev. 1/81
troaas xa s
TOWN OF SOUTHOLD
BUILDING DEPARTMEN4
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON TFiE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~ 017 8 4 0 Z Date ~T 19..`.:..!
Permission is hereby granted to: ,
.~:A-.~r...r..~.~ .
~t~'..~r.1.~.......a-n... ~x~`a..:c~,l~,e+~.~~r......,.<..,~....mice.,....~c.~,..~rr
............~,.~....C>~........ ~ ~
ct Premises {orated at .......................k...................!"1.......... .....`'!~1......................
....................................................................//.......................................l!.//.................................................
County Tax Map No. 1000 Section .......5?~.......... Bloppc~~k ~.7....... Lgqot No......°.2.1
pursuant to application dated ....................~~l~......Q..................., 19..~(., and approved by the
building Inspector.
Fee
iding Inspector
!~'f~ Bd
Rev. 6/30/80
J' a
TOWN OF SOUTHOLD
BUILDING DEPART4fENT
TOWN HALL
SOUTHOLD, NEW YORK 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE. 2/8/89•_...__•..
NEW CONSTRUCTION ...xg..OLD OR PRE-ERISTING BUILDING......4ACANT LAND........
Location of Property... .185 MECHANIC ST E.......... SOUTHOLD_.'
HOUSE N0. STREET HAMLET
Owner or Owners of Pro ert MIRIAM LYNNE RICflARDS
County Tax Map No. 1000 Section 61... Block 04.... Lot 29.......
Subdivision Filed Map ........Lot..........
Permit No. ..........Date of Permit ..........Applicant
Health Dept. Approval Underwriters Approval..............
Planning Board Approval
Request for Temporary Certificate Final Certificate
Fee Submitted: $
5-00
~')S
`rC"~ APPLICANTMIRIAM LYNNE RICHARDS
3`~
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rev. 10/14/88
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N/O/F THERESA
FROHNHOEFER
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PHYLLIS B. MALLGRAF
3 ! ADRIENNE B. OLlVER Q
i s> r~r h ROBERT H. BAKER
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na ENCLOSED ea.~ iSS h O
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99.83' S 76' 25' 30"
MECHANIC STREET
SURVEY OF
PROPER T Y
A T SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. Y.
1000 - 61 - 04 - 29
r~ ~ CERTIFIED TO
Scale 1 = 3O CENTfRBANK MORTGAGE CORPORATION
' Jan. 27, 1989 MlRlAM LYNNE RfCHAROS
ED LANp SG
'ir~yy~~ A bvCf• 9L
J ~ O S
'97~~a aseeeyoQb
Pnpusd in accortlanc. with tM minhnwn O. 19668
afandartl~ !or titb aurraYS n wta5/iahotl
by tha L.LAA.S. and approwtl and ado Nd ~PECONIC SURVEYORS, P. C.
Ior auM uu D7 TM N.w York SnN [.nd / (516/ 765 - 5020
TiHo AaaociaNa2 ! P. O. BOX 909
MANN ROAD
' SOUTHOLO, NY. 11871
89 - 111
BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY
TOWN OFSOUTHOLD CHECK
BUILDING DEPARTMENT SEPTIC r•oart
TOWN HALL
SOUTHOLD, N.Y. 11971 NOTIFY
/yp TEL.: 705-1802 CALL
Exanllned ...a~~~J/. 1..... 19..\9 MAIL T0:
pq ,
Approved ..a~/`~~Q 19 Permit No. ~7~~0 2 D CCe~pp pp .
Disapproved a/c fGD V
,
.
99 Y OF ~ THOLD
wilding Inspector)
APPLICATION FOR BUILDING PERP/IIT ~
Date ...°~L~~..-......., 19~~
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Pee accordin; to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises avai]able for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
i
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and C#~cF pplica~tle,L~v~~, Ordinances or
C .~s G~, d„ ,
Re,ulations, for the construction of buIldings, additions or alterations, or for remova 'or demohtton, as erein described.
The applicant agrees to comply with all applicable laws, ordinances, building csad~„Iaeusin~4 E"o`c$e,-and~ Fegulut~tir~s'~ and to
admit authorized inspectors on premises and in building for necessary 'nspections- x t~
~ ,.`~-c`,~ ,
ignature o"~'l~p~ arY{,tor 'wine, if'a corporation)
. G~.~-.... : ~ ~
a - ,,.,1,..
' (Mailing address of ap){hcaht)`
State whether applicant is owner, lessee, agent, architect, engineer, general contracjor, electrician; plumber or builder.
Name of owner of premises ..!f'1.l/~f~~... ~-.Yr?~l~!r~-.... ~ ~s ` ~ '
(as on the tax roll or latest deed~y,,. .
If applicant is a corporation, signature of duly authorized officer. -
(Name and title of corporate officer)
Builder's License No . .
Plumber's License No . .
Electrician's License No . .
Other Trade's License No . .
1. Location of land on which proposed work will be done . .
.
.1.8.s ...0.~~.~CH. Prr~(~. S%:. >1'.T..:~S~?G~?Gf~. N.~.t~... /1.x:7/
House Number /Street. Hamlet
County Tax i\lap No. 1000 Section Block , , , , _ , , , , Lot
Subdivision Piled hlap No. Lot .
(Name)
State existing use and occupancy of premises and intended use and occu
panty of proposed construction:
a. Existing use and occupancy .
n G
b. Intended use and occupancy ~~~K~.-.. U?.~
i
Re air , , , • . • • • • Rh applicable): New Building , , , , Addition . Alteration
P emoval
ature of work chec^k~,whi~ • • • , • • , Other 1Vork .
' Demolition
4. Estimated Cost , , , , , (Description)
dUi bQ
Fee
5. If dwelling (to be paid on filing this application)
ng units , , , , , , , , , , , , , , , Number of dwelling units on each floor , , , , , , ,
If garage, num ber of cars ~ . , . , , ,
~'r,nurnberofdwclli
6. If business 'xe occu ant s ecif nature and extent of each t e of use .
7, Di e P Y, P Y YP
~4W Q i ' if any: Front . .Rear •
Hei t 'erofStorics. Depth.
Di fr ~ ns of sa - e~sltU~,tur` alterations or additions: Front • • • • ~ • ~ • • • ~ • ~ • ~ ~ ~ ~ • ~ ~ • • ~ ' ' ' , • . .
De fi ai ( I . . Ileight . Rear .
' .Number of Stories .
' 8. Dir a~t !;~„ns.. ~ction: Front .
Hei~ht' . •t ,f+~i.k Rear ...............Depth
r #fit~.;•;t>,r~,,~~1Uml~r of Stories .
9. Size of lot i~orrt,.:.~°.a.:~..,.,.....~....,.:... Rear ' .
10. Date of Purchase Depth
Name of Former Owner ~ ~ '
]l. Zone or use district inwltich
Qremisesaresituated,,,,,,,,,,,,, '
Does ro osed constructron v .
~ P P ~ lolate any zoning law, ordinance or regulation: .
13. \Vill lot be regraded . ,Will excess fill be removed from premises: Yes Nc
14. Name of Owner of remises . Phone No. 76.5-;' S;-}U(Q
P ......M1~1~ "nng~;c.[la!dES .Address .
Name of Architect ,
...................Address ...................Phone No........
Name of Contractor .
P P ~ .y .......................Address .......Phone No.
?S.Is this ro ert loSated with in 300 feet of a tidal weCland? *YgS....NO....
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate alI set-back dimensions from
property Lines. Give street and bloc~C number or description according to deed, and show street names and indicate whether
interior or comer lot.
i
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i
APPROVED AS NDTED
DATE; °2 ~ B.P. q L
Sfl. '
Ndl°IFY BUILDING DEPARTM I NT AT
'i66.1802 9 AM TO 4 PM F R THE
FOLLOWING INSPECTIONS:
, i. FOUNDATION • 'TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH • FRAMING Nr PhUiM81NG ~ •
3. INSULATION
b. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALLI MEET
THE REQUIREMENTr> OF T!•~E N.V.
STATE CONSTRUCTION & ENERGY
!;ODES, Np7 RESPONSIBLC FOR
OF.SIGN OR CONSTRUCTION ERRORS
I
STATL• OF NE1V YORK,
COU,ti'T~' OF S.S
• • ~ • • ~ • ~ • • ~ ' ' ' ' ' ' ' ' ' ' ' • • • • • • • • • • • being duty sworn, deposes and says that he is the applicant
(Name of individual signilrg contract)
above named. i
Fie is the
(Contractor, agent, corporate officer, etc.) ~ ~ • • ~ • • • " " "
of said owner or owners, and is duly) autltorized to perform or have performed the said work and to make and file this
application; [hat all statements contaiined in this application are true to the best of his knowledge and belief; and that the
work will be perfomted in the mannerset fortlr in the application filed therewith.
Sworn to before me this
p i~
• P .......day of , 19 g.~
Notary Public, .......~...~.,pk,~~
County T>p~ ~ /J , ,p ~
HELEN K. DE VOE .~~Y7 • • 4~,~-~~r,K;EULC~'~!
NOTpgY PUOLIC, State of, New York v ' ' ' ' '
No.M1707879,SuNolk~Coun (Signature of applicant)
Term Expires March 90,19